What is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome is a common neuropathy disorder, affecting approximately 3 to 6 percent of adults in the general population.
The carpal tunnel is a narrow passageway of ligament and bones at the base of the hand which houses both the median nerve – which innervates the thumb, as well as the index, middle, and ring fingers – and the tendons that bend the fingers. Carpal tunnel syndrome occurs when that nerve becomes pressed or squeezed at the wrist, causing pain, numbness, and tingling in the arm.
How Does This Happen?
Oftentimes, swelling of the tendons or thickening from the lining surrounding the tendons can cause the median nerve to be compressed. The symptoms start with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers.
Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. People with carpal tunnel syndrome often have trouble performing fine motor tasks such as fastening buttons or turning keys. Others cannot tell the difference between hot and cold by touch.
Carpal Tunnel: Here are the Facts
The National Institute of Neurological Disorders and Strokes (USA) indicates that carpal tunnel syndrome is the result of a combination of factors that reduce the available space of the median nerve within the carpal tunnel, rather than the problem with the nerve itself. Carpal tunnel syndrome has historically been associated with tasks including repetitive hand motions, awkward hand positions, strong hand gripping, mechanical stress on the palm, or vibration.
More recently, other factors contributing to the development of carpal tunnel syndrome have been suggested, such as genetics, hand and wrist position, pregnancy, health conditions such as arthritis, diabetes, gout, hypothyroidism, tumours of tendon sheaths, and wrist cysts. The risk of developing carpal tunnel syndrome is not limited to people in a single industry or job but can be especially common in assembly-line work such as manufacturing, sewing, and cleaning, as well as meat, poultry, or fish packing.
Interestingly, women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself is smaller in women.
Diagnosis and Treatment
Early diagnosis and treatment of carpal tunnel syndrome are important to avoid permanent damage to the median nerve. A medical examination of the hands, arms, shoulders and neck can help determine if the person’s discomfort is related to daily activities or another underlying disorder. Routine laboratory tests and X-rays can reveal fractures, arthritis, and detect other diseases that can damage the nerves such as diabetes.
Specific tests are available, like the Tinel test: in this test, the doctor taps on or presses the median nerve. The test is positive when tingling occurs in the affected fingers. Another specific test is the electrodiagnostic test, which is a nerve conduction study that measures the electrical activity of the nerve and muscle.
When symptoms of carpel tunnel syndrome are mild, it can be treated with rest, anti-inflammatory drugs (ibuprofen), ice, and/or a splint. Specific exercises supervised by a physical or occupational therapist can also be beneficial. Surgery may be required if symptoms are severe and not improved by less invasive treatments.
In Your Workplace
Carpel tunnel syndrome can be prevented by designing the workstation, tools, and the job around the worker, rather than the other way around. Educating employers and workers on appropriate workstation design and body positioning during work can go a long way towards reducing awkward wrist positions and minimizing the stressful effects of repetitive motions.
If your workplace would like guidance on designing and implementing ergonomically correct workstations, please reach out to our team! We specialize in this area, and are happy to offer our advice or services!